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BUILDING. INSPECTOR RECORO
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDrI DEI-CATATION
<br />I h.rchy lith undcr lcnrlry of F4ury rh.t I tm .kfrpr tn)m tlE C.rrk_.t6' l.i(n\. L2e lnr !h. tullowrt Elsn (S.r 70!l 5
<br />Br!N( .rl Pn'fc$r'n Ciir) Any C y o, G,ud, *hrh Frurr . Frd b onnd.t, .116, mprur. d.frnlh or EFr 6y
<br />juru., Frr ro tr! Eru.M. .lr, rrluc rtE .l?lrrnr for rkh Fmr h fik . {!Etj nd.Enr rh, h. ot {r n llcaGl Frrd
<br />k' r,E F,vlrsns ol rlt ConrBriri l,x.n*J |l* (Clrqi- 9. CommndS wnh sers. '7uD or DNFsn I ol rlE Bunds .nJ
<br />Pnr.*r,n. CoJ.) o, rhr! lE Msh. r.r.nyr th.Ffn,m I rh. b.{r ttr rlE .lLlcd .rtr{rio. Anyvr lrionof SdDn 70115 br.hy
<br />apFltrrtrlntr!Frm run.rlslhc rpp[umr h a.rvrlp.nrll,oln rn[Elhunv.hu Eldous(t!oo).
<br />l, .. owE or rlI potEny. d fry .,!ft,y..t *'lh e.!.. a
<br />'rE!
<br />$l. lrtrIEnr.r.n. *dl & rlE krl d rlE <urE r d
<br />lrc al qofi.EJ nr Et (Sa.?O,l.t, BuG3t DJ PmLa$n! Cq,.r TIE Co E_-.rd''Lffibw&Bd+r trouorB.l
<br />rh. FIrny 'lE h{ lr q rp.!6 rlrc4 .nl eho ds qr5 H)lt hhrclf q h.rrlt or rhmlAh htr d h.t o*r .tq iy..!,
<br />tbvid.J rhlr :kt oINwftds G *n hr.RLd orod.E1, fo. sL Il. bM, rh. h{ juU or E{ntrn ir e! wihin 6m Ft
<br />of LlrpLlla rh. oqftr Buil.l6 vi! tuE rh. buni.n of I'trvi,B rh, ll or rlE ,jrj [n tu!! o. intnr dE FDpdq for llE purro. ot
<br />_l,!io*m,olrlEpn)ndy.m.rrluntlyeodr ms *dh hri(J (dr!d.n !' o.{rud r h. F'F! ( 5N ?04!. Auifts
<br />rnl thfcssDnCod.:Ihc(ir.u.cntrtl,rcnsclj*doc{norapt'lyn)rnouncrollffop.nywhohu'ld{ r,mF)v.slhcron.
<br />atui *lx, onra(r! |,tr 1eh pft,J.( r *(h 1 Contr '(, la.nkl Ni\u.nr h rtF Conr.r.nni L!.r{ ttrw)
<br />_l rm.(mpr ud.r Sturbn
<br />Irrl.,_
<br />]yIIXAEELCAMIE$A N
<br />DFCLARATION
<br />I h.Ehy.finmuBkr FEhy of tE.pry oE ofrlr n,ll'urt &.hr.ri'nr
<br />-l
<br />hlvc,Il will runrrm. C.drrf,rr. DlCon(nt t' S.lf-ln\ur. kn 'ork.c' ( onln.nur Dn- is pn,vrl&l for hrSc.rrn !7{Uolrh.
<br />bhtr(irl..lnrrhc p.',orron..ol rh. wrk rorwhlhrh. p.mn r hnrcJ
<br />I h.w .,n r l Md.n *ort r' .onlllNrrn. n ur.E.. .! r.llu!.J lty Sdrr. ]7m of th. lrtrn cd.. tn lE n .i,ll]a. ol
<br />rrx *)rl li{ *h.h rhr Fm, E FsrJ M, wrrtdi $rqrndx)n 'n(rhr rftr lrl F,ry mr$.r c:
<br />PolLy N!Bbcr:-
<br />_l.tn',trh, nrhr Frlo.mtu. olrh. *ortforwhrhrhn p.rmd tr sru.J.l lll d .r{,h! !., F$n n y mumr
<br />$ .r h hc()r ruhJc( t' rhc s si ('mpcn!.r ion liwr ol C.hl,,mu, DJ tsN(h rrl \hould lE ,rm ubr( r. rlt
<br />k,*cn' drqus.rirn r,rvBion\ ol S.rr!'n 1700 oI rh. Uh, Gil.. I firll rodhp h uon{ y w h lh'E r'rorRionr
<br />WARNING Frilur h Gu. qntcr' c..i{E.slr'n d,EEr. n lnl,*tuL u] ttil rur,Fr -.rnl)ldF. ro ffml FD|B..,l(irrl riftr up ro om hunlGl lbusrn d.lls (!l{I).{In). h Jddr'. b rlt !{r or orqEnE rr, dd8.t .. Ir.d.J nt r,x
<br />S(rNr lort "l rh. trh{ ('ixlc. uil(rc< Dl ix,my'i re!
<br />\ppli.{nl:
<br />UIEISEILqONIBASPA
<br />DECIIMIIQ!
<br />I h.Fhy lllim unLr tiMfty ot F,lry rht I m le.ntl uLt r F,vs.n ol Chrtid o l.rIlEB h! *dh Serp. 7(mt of D,vBnn !
<br />o, rh. ,luw$ .ft1 PNi.sbnr Cdl., ,n my k.n( s o fxl n,Br lil.fier
<br />CqlsIA.l1l:IlQNIl8DlIiG-^GEMX
<br />I lEFhy .rlim u sFulyofFrJrrrh, .r.!.NniturnnLnlo8tem,r(tr'rEFrf(ll]rn.ortlE*,tlorwhxhrhlFtu6
<br />6ruJ (S& 1097. Crv C ).
<br />^ITLIIAILDIiI.IJAATAIiI tEtr$yillnrumlci FnJlry olFlrrtry oR ol rhc nnk'wr! d.rlrr.rk,r:
<br />Dcnrrl(r'tr I,crnnB \tr(o! N({rlcJrntr J:clciaj llc!uhrr}ns I l . {r. Prn6)
<br />Rc{u(cd klr$dl Mr irD.
<br />_l(n,tyrhd rh. n d.fll rc8ul.nonr E8rdm8 1\tr (o( ,cmrvrl u. nrlarpltr{t'k i, rhtr pn'F..'r
<br />I ..n'ry 'h, I h.w 8.1 ihs .n lrir'. url dli. rh, rh. rh)k ' I r8r k, c.,r9l, wrh .ll C! t rnl
<br />nlmRcr .,n Sr.'c l:e. E!'i ry b hru.rr
<br />lhnc mnri,RJ pn,Fnv n, ffF!1
<br />f,,,,.rnl rr AE.nl Si,lnrhrrc
<br />u...r in .t!l h.Elry turtl,rir RtE.ddra oI rhl Cly .nj O
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu lat ion/E ne rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handica p Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL 4/4ln 1 wtwq<a h-> -t
<br />Certiticate of Occu utpancy
<br />Notes, Remarks, Etc
<br />LEtr(CL$:_
<br />Drl. C.nr*tor:
<br />Erection Pads
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